Order Form for Mother's Bracelets

Name

Phone

Address

Email

City, State, Zip

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Length (measure your wrist and add 1/2" to 3/4")

Single Strand     $30

Double Strand   $60

6.5"

8"

Triple Strand     $90

7"

8.5"

Additional $5 for each 1/2" larger than 8" More than 8 letters per strand add $1 each Shipping $3.85 Priority Mail - USPS

7.5"

Other

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First Strand

Name or Initials (more than 8 letters per stand add $1 per letter)

Birthstones (list in order to be shown.  Multiple stones used if only 1 or 2 stones listed.)

Traditional Birthstones: Jan - Garnet, Feb - Amethyst, Mar - Aquamarine, Apr - Crystal, May - Emerald, June - Alexandrite, July - Ruby, Aug - Peridot, Sept - Sapphire, Oct - Rose Sapphire, Nov - Topaz, Dec - Blue Zircon Alternate Crystals: June - Pearl, Oct - Opal, Nov - Light Colorado Topaz Please note all birthstones are Genuine Swarovski Crystals / Swarovski Pearls.

Special Instructions

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Second Strand

Name or Initials (more than 8 letters per stand add $1 per letter)

Birthstones (list in order to be shown.  Multiple stones used if only 1 or 2 stones listed.)

Traditional Birthstones: Jan - Garnet, Feb - Amethyst, Mar - Aquamarine, Apr - Crystal, May - Emerald, June - Alexandrite, July - Ruby, Aug - Peridot, Sept - Sapphire, Oct - Rose Sapphire, Nov - Topaz, Dec - Blue Zircon Alternate Crystals: June - Pearl, Oct - Opal, Nov - Light Colorado Topaz Please note all birthstones are Genuine Swarovski Crystals / Swarovski Pearls.

Special Instructions

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Third Strand

Name or Initials (more than 8 letters per stand add $1 per letter)

Birthstones (list in order to be shown.  Multiple stones used if only 1 or 2 stones listed.)

Traditional Birthstones: Jan - Garnet, Feb - Amethyst, Mar - Aquamarine, Apr - Crystal, May - Emerald, June - Alexandrite, July - Ruby, Aug - Peridot, Sept - Sapphire, Oct - Rose Sapphire, Nov - Topaz, Dec - Blue Zircon Alternate Crystals: June - Pearl, Oct - Opal, Nov - Light Colorado Topaz Please note all birthstones are Genuine Swarovski Crystals / Swarovski Pearls.

Special Instructions

You will receive an email confirming your order and total cost.  Any problems filling out the form, please email me at:  RbrRm@aol.com or call: 717-519-1991.  Thank you.

Mother's Bracelets

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